“…Later, rare fully human rearranged V H and V L variable domains were discovered that were autonomously stable and monomeric and large phage display libraries were constructed by randomizing their complementarity-determining regions (CDRs), although it was clear from the mid-2000s that certain CDR sequences (potentially low in hydrophobic content and rich in negative charge) were better compatible with solubility and stability of these molecules ( 9 – 11 ). There are now many examples of fully human antibodies (primarily V H s) isolated from such libraries against a variety of targets, including α-amylase ( 12 ), β-galactosidase ( 13 , 14 ), Candida albicans MP65 and SAP-2 ( 15 ), carbonic anhydrase ( 12 ), CD154 ( 16 ), CD28 ( 17 ), CD40 ( 18 , 19 ), CD40L ( 20 ), Clostridium difficile toxin B ( 21 ), EGFR ( 22 ), glypican-2 ( 23 ), glypican-3 ( 24 ), human serum albumin (HSA) ( 25 – 27 ), lysozyme ( 28 – 30 ), maltose-binding protein ( 31 ), MDM4 ( 32 ), mesothelin ( 33 ), TNF-α ( 34 ), TNFR1 ( 35 ), and VEGF ( 22 ). These fully human V H /V L sdAbs exhibit a variety of antigen-binding modes and functional activities and several have entered clinical development, where they have been generally well-tolerated albeit unexpectedly immunogenic ( 36 , 37 ).…”